Blood and Loss
by Fille de Tsuki
Summary: Dean may have missed something important. Sam misses having the normal amount of his abnormal blood. And they both miss the way things were before. Missing hurt!Sam scene to 4.19 “Jump the Shark”.


**Title**: Blood and Loss**  
Author**: Fille de Tsuki**  
Fandom**: Supernatural**  
Rating**: Teen (Same great taste as PG-13!)**  
Type**: Missing scene**  
Genre**: Hurt/comfort, angst**  
Number of Chapters**: 1**  
Word Count**: ~3100**  
Characters**: Sam, Dean**  
Pairings**: None**  
Spoilers**: Through 4.19 "Jump the Shark"**  
Warnings**: Rather a lot of blood. Neither plot nor closure. Loose interpretation of medical knowledge. Mostly in the third person POV of someone mildly incoherent at the time, resulting in angsty humor and melancholy.

**Summary**: Dean may have missed something important. Sam misses having the normal amount of his abnormal blood. And they both miss the way things were before. [Missing hurt!Sam scene to 4.19 "Jump the Shark".]

**Author's Note**: Yeah, I know that episode 4.19 was aired quite some time ago. I started writing this many months ago, and have edited it almost obsessively. ...But I'm sure there's still errors I have missed! Gah!

I know that I prefer LiveJournal -- for ease of formatting and review response among other reasons -- and so do some of you. So you can hop over to my LJ to read this if you want! I allow anonymous comments there, so you don't have to have an LJ account. Just make the necessary adjustments to this address: fille-de-tsuki (dot) livejournal (dot) com (slash) 654 (dot) html

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**O0O0O0O**

**Blood and Loss**

**O0O0O0O**

_To unexplain the unforgivable__  
Drain all the blood and give the kids a show__  
By streetlight, this dark night  
A séance down below__  
There's things that I have done__  
You never  
Should ever know_

_And without you  
Is how I disappear  
And live my life alone  
Forever now_

_Can you hear me cry out to you  
Words I thought I'd choke on?  
Figure out  
I'm really not so with you anymore.  
I'm just a ghost__  
So I can't hurt you anymore._

_And now, you wanna see  
How far down  
I can sink?  
Let me go!_

_And without you  
Is how I disappear  
Forever  
Forever now_

~ Selections from "This Is How I Disappear" by My Chemical Romance

**O0O0O0O**

When Dean got back with the first aid kit from the car, he expected to find Sam lying on the couch, or at worst on the floor, in a position to slow down the blood loss -- legs bent and arms lifted -- waiting to get stitched up. That would only be reasonable, right?

Okay, so Sam's legs _were_ drawn up, and his arms _were_ up, resting on his knees, semi-crossed so his hands could press the cloths to his bleeding forearms. But that was where the reasonableness ended. Sam was not lying on the couch, or on the floor. He was still sitting on that table where Dean had left him. And now his head was hanging forward limply, and he hadn't even twitched when Dean reentered the room. Bad signs.

As he came closer, Dean saw that the cloths staunching Sam's injuries were soaked through and dripping slightly, and he realized with a sick twist in his gut that he'd figured wrong. He'd glanced at the bowls the ghouls had set out to catch Sam's blood, seen less than high school kids gave at blood drives, and figured they were good with a few stitches. Okay, a lot of stitches, but still good. And he'd freed Sam and helped him sit up.

It probably was a good idea, psychologically, to get someone out of the position they'd been tied and tortured in. (_You call those crude gashes torture?_ part of him had scoffed, and the rest of him was scared by this part of him that saw things so different after Hell, this wounded-beast part.) But it definitely wasn't such a great idea, medically, for someone bleeding out to sit up. And Sam was still bleeding heavily -- no arterial spurting, but bleeding a lot more heavily than he'd expected. This was bad.

**O0O0O0O**

"Hey, Sam?"

Sam thought Dean's voice sounded like underwater. He looked up, and the black at the edges of his vision pulsed inwards for a second. But then the black receded like the tide, frothy sea foam popping on the sand, and he could see Dean's concerned face, though the colors were almost gone now. Low saturation on a photograph.

"Dean? Don' feel s'good." And his own voice sounded underwater too, and clumsy. His hands were going numb and tingly at the same time, and even with his brain as dull and fuzzy as it was feeling, Sam recognized the symptoms of blood loss. Probably shock too. "M'blood…" His words trailed off as he realized he didn't know what he'd been trying to say. Fantastic.

"Yeah," Dean said, "you're losing it faster than I thought." He put one arm behind Sam's shoulders and pressed down on Sam's chest with the other hand. "Come on, let's get you lying down."

It was wrong to need Dean's help because Dean didn't need another burden and Dean would just go away again and Sam needed to be strong enough to end the whole mess but… Sam was tired. Tired enough to feel like he could pretend that he was the old, human Sam being taken care of by the old, pre-Hell Dean. And hey, this wasn't anything big, just a little blood loss. "Okay." Sam sagged into Dean's hold and let his brother lower him back onto the table. The hole in his side stung and ached at the movement, but he pushed it to the back of his mind.

Dean lifted Sam's arms in the air and pressed his own hands over Sam's, tightening the grip on the wounds. That action reignited the lines of fire along his arms, but Sam was pretty sure that his only reaction to the pain was a loll of his head and a strangely slow-feeling wince.

"Just- just hold on there, okay?"

Sam attempted a nod. Then Dean moved away and Sam just lay there. His hands felt wrong, like they were dying, like he should be relaxing them, letting them drop. But he knew they were a good ways away from serious tissue damage. He was supposed to keep them tight on his wounds, slow the spill of his tainted blood. Wouldn't want to waste blood -- that's all the new, hollowed-out Sam was worth. So he lay there clutching his arms, slowly being overtaken by the tingling numbness in his hands, his legs, his vision, his mind.

But then Dean was back, tying something painfully tight around Sam's right arm above the elbow. Tourniquet, cutting off the brachial artery. Risking permanent tissue damage to save life. And now Dean was on his left, doing the same to his other arm.

Sam turned his head to look at Dean. "'S bad?" Ugh, he sounded drunk. And still underwater.

Dean stopped moving for a second, looked at him, and Sam couldn't read the expression on his brother's face. He'd blame it on the blood loss, but Dean had been getting harder to read for a while, looking at Sam like a stranger. And maybe he was. Maybe they both were. Sam wasn't the Sam that Dean had left behind. That old Sam had died pretty quick after his brother, everything feeling and good torn out by hellhounds and cauterized with the knowledge that Dean was suffering in Hell because of him, because of the weak old Sam that wouldn't do what needed to be done. The new Dean that came back wasn't the same either. Usually the approximations from what they remembered worked well enough, but not always. Like a secondhand jacket that didn't fit quite right, tailored to someone else.

"Yeah, Sam," Dean said, and Sam tried to remember what his question had been. "It's pretty bad. But nothing we can't deal with." Then Dean broke Sam's grip embarrassingly easily and took Sam's left arm in his hands. "Let's see if I can fix this or if we're going to have to get you to the hospital and worry about breaking you out of suicide watch later. Hopefully before they figure out that Adam-" Dean paused to clear his throat, "that Adam's dead and we're the two strangers who were last seen with him."

Sam tried to focus on keeping his right arm up without support. It was shaking. Slowly, Dean's words resolved into mostly sense. Except the bit about suicide watch. "Wasn't suicide. Was ghouls."

"I know, Sam." Dean gently peeled the sodden cloth off Sam's left forearm. "But wounds like these? I don't know, maybe we can play up the wrist ligature marks and hole in your side, say you were attacked by crazies. It's true enough." He examined the slices up Sam's arm, now oozing instead of pouring blood.

The sight of it made Sam a little sick to his stomach. Or maybe that was the blood loss. Or it could be a concussion -- how long had he been out before he'd come to, tied to a table? He'd been pretty far under, he thought.

After a few seconds, Dean said, "I'm going to have to clean this off to get a good look, okay?"

Sam felt a brief surge of anger that Dean was talking him through what was going on, like Sam was a child still. But, honestly, odds were good that he needed Dean's narration. His brain was having much the same problem as his vision, with the encroaching waves of black tingles and low saturation. At this point, he couldn't even see much unless he really focused on it.

Then Dean was shaking his arm a little, which, _ow_, and saying, "Sam? Hey, you still with me?"

Oh. Dean wanted to know he was conscious. Sam kind of wished he wasn't -- he felt like crap. "Stop shakin' m'arm. Hurts. 'Cause, y'know. Moves the… the cut. Cuts. Ow." Wow, he was drunk. No, not drunk. Blood loss. Sounded kinda drunk. His tongue and his thoughts felt slow, clumsy, heavy.

Dean gave a relieved snort. "You sound drunk."

Sam huffed irritably. "Blood loss, jerk."

"Yeah, okay," and Dean was back to business, "I'm going to rinse this out with holy water, kill two birds with one stone. Figure it'll take care of any… unholy ghoul spit or whatever."

At first, Sam almost laughed because the idea of worrying about ghoul saliva while he'd been drinking what he had was like worrying about a splinter in your finger when your thumb had been cut off. He thought of that phrase Dad had used with the air of an old saying, _Can't turn a vampire into a werewolf_. Had struck him as funny (especially back when he'd thought vampires weren't real), right up until that thing in Oregon with the demonic virus and his immunity to it had brought the saying to mind in the worst way.

Suddenly it hit Sam that Dean was going to pour holy water on his open wound and… Sam actually didn't know if it would react. A rock took up residence in his already queasy stomach. He knew the holy water wouldn't burn his skin, never had, but his blood? He'd been afraid to try it since starting up with Ruby again. And even the ghoul had said his blood tasted different.

But he'd barely had time to think that before Dean already had his flask of holy water out and open and pouring over Sam's wound. And, okay, so it was maybe steaming a little, tiny wisps, but that could just as well be from unholy ghoul spit, and he didn't think it hurt any more than when he'd used holy water to flush out those wendigo claw gashes up in that Michigan forest a while back, when he'd still been teetotaling before the thing with the magicians. Nor was it worse than dowsing those red cap bites when he was, what? Sixteen? He hated red caps. Freakish little…

Sam's left arm dropped lightly to his side, startling him. He'd drifted off, but apparently not for too long because Dean hadn't realized, had let go of Sam's left arm. Sam could feel more than see his brother leaning over him to get at his right arm. And Dean was still narrating, "intact, which is good too. So, if your other one's the same, I should be able to fix you up here. You still with me?"

When Sam opened his mouth to respond, a yawn escaped. "Hnn." Sam tried to focus his eyes on Dean and was rewarded with the sight of a furrowed brow and a pinched mouth. Worry. But was it because the new Dean was worried about the new Sam, or because the old Dean would have been worried about the old Sam?

"Hey, just hang in there, Sam. I'm just going to check out this arm, and then we can get to the fun part, okay?"

"Stitches. Great." Sam rolled his eyes and temporarily lost his vision to frothy black and afterimage sparklers for his efforts. Not good.

"Yeah. Get you stitched up," Dean began to prattle as he rinsed out and checked over the slashes on Sam's right arm, "fix up the hole in your side, get some fluids in you, and you'll be good to go in no time. Nothing heals like a Winchester. Hey, you put together some of those hoodoo healing poultice things again, and you'll hardly even have scars when you heal up. Wouldn't want to mess up your good looks, right?"

That was a question. Dean wanted to know if he was still conscious enough to respond. He checked his short-term memory for what Dean had been saying. Worrying about looks? "Sounds more like you."

A quiet sigh of relief. "You're right, I am the good looking one. But think of it this way: You're like a consolation prize for chicks who don't measure up to my… _stringent_ requirements." It seemed Dean was done with his inspection, because he let go of Sam's arm and stood up.

"You mean like… the doctor, Cara? Wasn't a siren, an' she liked _me_." Sam couldn't tell what Dean was doing from the sounds, and, oh, looked like Sam's eyes were closed. Huh. Bright side: vision couldn't get blurry this way.

"Total fluke. If I'd talked to her first, she'da been all over me."

"An' the redhead in tha' bar las' week?"

"Dude," said Dean's disembodied voice, "she was like forty. The cougars always go for you."

"Thirty-four. She was a micrologist." Sam was pretty sure he'd said _microbiologist_ wrong. Oh well. "She was nice. Shoulda gone for you. Too good f'r me."

Dean was silent. He probably didn't understand was Sam was saying.

Sam explained, "I shouldn' have good people. Get 'em- Get 'em hurt. Dead." Like Jess. Like Mom and Dad. Pastor Jim, Caleb, Meg Masters, Ronald Resnick, Madison, Henrikson, Nancy, Ash, Pamela, so many others. Dean. "Sorry 'bou that." He laughed so he didn't start crying. "This's why we can't have nice things. 'M poison. Got poison in me. Can't ev'n… Can't ev'n keep myself good."

Wait, no, wasn't supposed to be telling Dean about that. Then Dean would know this new Sam was turning. For a good reason, but turning. (Gordon'd had the right idea after all, maybe more ways than one. Become something unnatural to take out something worse, and then, if he couldn't turn back… Well. If he was too far gone to do it himself, Dean had _promised_.) But if Dean knew, he would leave again, for good. "Sorry." And the new Sam was weak, couldn't take that. No no, the new _Dean_ was weak. _Dean_ couldn't take that. "Sorry."

Dean still wasn't saying anything. Was he still listening? Sam wrenched his eyes open, found Dean sitting at his right side. He'd barely managed to focus when Dean said, voice flat, "This is gonna hurt, okay?"

Sam hardly had time to process that before his right forearm picked up the sensation of wet, and then fire. Antiseptic bubbling on his arm. He made some sort of noise. He could only hope it was a curse or groan and not anything embarrassing. But judging by Dean's "Hey, hey, it's okay. Just take a second. Gonna stitch you up; it'll be fine," it was probably a whimper. Man, the blood loss and maybe-shock were messing with his pain tolerance. Oh, and the maybe-concussion. Probably-concussion.

And then Dean was stitching him up. It hurt the over-sensitized flesh of his forearm, but the rhythm and familiarity of it must have been soothing on some level, because Sam found himself lulled into a sort of doze. Or maybe it was the adrenalin crash and blood loss and maybe-shock and probably-concussion…

Sam came back to himself as Dean tied off the last stitch.

"Let's see how this holds up." Dean fingered the knot of the tourniquet on Sam's right arm and gave him a cover-up smirk. "You may experience some slight discomfort."

Then he removed the tourniquet and, "Ungh. Liar. Tha's some pretty intense discomfort."

Dean snorted something like a laugh as he inspected the results of his work. "Suck it up, Francis. Thanks to my amazing medical skills, you've still got blood in you."

_Too bad you were here, then._ (But no, he'd thought he was done with those sorts of selfish thoughts. New Sam was determined and powerful, pushing past heartsickness and soul-exhaustion and gnawing emptiness so he could do what he had to.) Wait, had he said that selfish thought aloud? Dean was turning away, moving around behind Sam's head, and not punching him, so probably not. The thought must have just been particularly loud. And everything else was still muffled and on the fritz, so that was confusing.

Sam roused to Dean loosening the tourniquet on his left arm. Sharp tingles of pain rushed down to his fingertips, but he was able to bite back any noise. Wasn't Dean supposed to be stitching that arm, not opening the tourniquet and letting all his blood out? Sam reopened his eyes (when had he closed them again?) to glare. "Wha's tha' for?"

"Well, I figured maybe you'd want use of your left hand after all this, so I'm letting some blood through."

"Lettin' all my blood out, jerk. Need that." New Sam's blood was the only important thing left of him.

Sam didn't think it was funny, but Dean snorted. "It clotted up a little -- it's not leaking fast as it was before. I'm not going to let you bleed out, Sam."

Sam searched Dean's eyes. He was telling the truth this time, Sam thought. Though it was hard to tell with new Dean sometimes. "Okay then."

"Maybe you should take a nap, Sam. Let me take care of you, okay?"

That sounded good. "Okay."

Sam closed his eyes and drifted off to the oddly reassuring feel of his brother squeezing his fingertips, one after another. _Checking capillary refill_, his mind offered. He was pulled back towards consciousness by a wet burning sensation on his left forearm, but that ended, and Sam fell back into blackness.

**O0O0O0O**

Dean pulled the stitch closed, paused, and wiped his brother's blood off his own left hand onto a towel he'd grabbed from the kitchen. He pressed that hand against his eyes, trying to cut off the burning behind his eyeballs.

_Got poison in me,_ Sam had said. _Can't even keep myself good._

Dean had wanted to shake his brother, yell at him, _Why the hell not? You've had that demon-blood poison in you since you were six months old, and you spent more than _two decades_ being good. And now you're defying your precious angels and letting a demon lead you around by the nose. What changed? You can't even tell your brother who went to _Hell_ for you -- not to mention who gave in and broke the first Seal -- what you're doing?_

Add that to the list of Dad's lessons that Sam had taken to heart late in the game: need-to-know only. And if you weren't him, you didn't need to know.

"What's so bad you can't even tell me, Sammy?" Dean whispered. "Why can't you keep yourself good?"

But Sam just lay there, no answers forthcoming.

Dean sighed, and then started up where he'd left off. He'd just have to stitch Sam up as best he could. For now, that was all he could do.

**O0O0O0O**

_Finis._

**O0O0O0O**

Leave a review! Tell me what you liked, where I could improve, whether I misspelled a main character's name, so on and so forth. Even just a, "Read it. Not bad," would be great! ^_^


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